Nursing Informatics in

China
HEALTH INFORMATICS has been greatly developed
in China. Significant resources were committed to construct
and improve the health information system.

Approximately 35–40% of hospitals have constructed hospital

information system. Over 80% of medical organizations
above the county/district level, 27% of town level hospitals
and all CDC above the county/district level can transmit real-
time epidemic situation reporting through public health
information system.

However, lack of standards became a bottleneck to utilize

and improve health informatics. China has adopted some
vocabulary, classification, coding standards and message
standards. Moreover, several national standardization actions
for health informatics have been taken. In the process of
standardization, the main barriers consist of financial,
technical, cultural and language problems, legal and ethical
concerns and others.
Hospital information system

Many hospitals have constructed

HIS. According to the Ministry of
Health in 2004, there were 6,063
hospitals out of 15,924 that had
established hospital information
systems.

It is estimated that about 70% of

county-level hospitals and above
have constructed HIS by mid-2007.
In 2004, the total cost for information
technology (IT) in health sector was
estimated at approximately RMB 3.5
billions (US$423.5 million), which
increased 25% compared with 2003.
Positive effects of HIS in China
Today, HIS is not only a symbol of modern management, but
also one of core competence of a hospital

changed the style of hospital management

offered tremendous opportunities to reduce
clinical errors (e.g. medication errors, diagnostic errors)
support health care professionals (e.g. availability of
timely, up-to-date patient information)
increase the efficiency of care (e.g. less waiting times
for patients)
Current status
Computers began to be used in hospitals in China in 1970s, but
used as hospital information management since 1984. According
to the contents, styles and scopes, HIS in China experienced four
phases[3]. They are as follows:

(1) Stand-alone. Mostly used in out-patients charge, in-patient

charge and drug warehouse management during the late 1970s

and early 1980s.
(2) Department local area network. Representative applications are

inpatient management; outpatient charge and drug deliver system,

and drug management system.
(3) Integrity of hospital information system. Many big hospital

constructed integrity hospital information system on ethernet over

100m since early 1990s.

(4) Telemedicine. With the development of IT and network, many big

hospitals commenced to study implement telemedicine, through

which the diagnostic digital images such as CT scans, MRIs and

ultrasound CT can be transmitted.

" No. 1 Military Project“
"No. 1 Military Project" was important in China's HIS development[3].
This project is a hospital information system consisting of over 30
basic subsystems. It was developed by General Logistics Department
of PLA collaborating with Hewlett-Packard in 1997. The project has
achieved success and improved the development of health informatics
in China. So far, over 200 hospitals have adopted this system. This
kind of HIS has become a succeeded and advanced representative one
in China. The HIS of "No. 1 Military Project" was applied in
Xiaotangshan hospital during the outbreak of SARS in 2003. The
patients suffered SARS were treated and the system played an
important role and was praised highly by specialists.
Although construction of HIS has achieved greatly, yet most HIS
concentrates more on the fiscal operations of a hospital and the
administrative aspects. Only 10% of hospitals with HIS have developed
patient-centered Clinical Information System, while 5% are
constructing Picture Archiving and Communication System.
Main problems
1.Lack of
Standardization/Interoperability
2.Unified Layout of Software
Systems
3.Models of Hospital
Management